AB1565 IBD AND LIGAMENTOUS LAXITY ASSOCIATION
Authors: C. Bentivenga, A. Varani, N. E. Politi, E. R. Cosentino, F. Rizzello, C. Calabrese, P. Gionchetti, C. Borghi
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Inflammatory Bowel Disease (IBD) is a group of chronic relapsing-remitting diseases characterized by intestinal and extra-intestinal manifestations that unfavourably impact patients' physical and mental quality of life. Recent evidence points to a possible higher incidence of Joint Hypermobility (JH) or "ligamentous hyperlaxity" in IBD patients compared to the general population and particularly in younger and female subjects with IBD. Ligamentous hyperlaxity represents a little-known benign clinical condition characterized in its asymptomatic form by joint and ligament hypermobility. <h3>Objectives</h3> the aim of this study is to determine the prevalence of ligamentous hyperlaxity in a cohort of patients with IBD. <h3>Methods</h3> we evaluated 130 patients afferent to the joint clinic of the "Centro Regionale per le Malattie Infiammatorie Croniche Intestinali "Massimo Campieri" e MI Borghi", located at "Sant'Orsola-Malpighi" University Hospital in Bologna, in the period between June 2021 and November 2022, allocating them into 3 groups: 1) Ulcerative Colitis (UC), 2) Crohn's Disease (CD), 3) Indeterminate Colitis (IC). None of the patients was affected by hereditary collagenopathies. Out of 130 patients, 47 were affected by Ulcerative Colitis (UC), 78 by Crohn's Disease (CD) and 5 by Indeterminate Colitis (IC). The mean age at the time of the visit was 45,32 (±12,86 range 24-78) for patients with UC; 47,35 (±12,65 range 22-70) for patients with CD; 45,00 (±12,16 range 26-62) for patients with IC; in terms of sex: 47 men (20 with UC, 27 with CD, 0 with IC) and 83 women (27 with UC, 51 with CD and 5 with IC). <h3>Results</h3> 34 out of 130 patients presented ligamentous hyperlaxity according to Beighton's criteria (pt ≥ 4) (26,2% of total, 16 UC, 17 CD, 1 IC). Of the 47 patients with UC, 16 had ligamentous hyperlaxity (34%). Of the 78 patients with CD, 17 had ligamentous hyperlaxity (21,8%). Of the 5 patients with IC, 1 had ligamentous hyperlaxity (20%). It emerges from this analysis that the highest prevalence of ligamentous hyperlaxity occurs in patients with UC, compared with CD and IC. Chi-square test for independence was performed by comparing the variable ligamentous laxity with the variables IBD, UC, CD and IC. The groups CD and IC did not show any statistically significant result with regards to ligamentous laxity whereas we did observe a statistically significant higher frequency of ligamentous laxity (p-value &lt; 0,05) in the UC group. <h3>Conclusion</h3> a close association between Ulcerative Colitis and the presence of JH, especially compared to Crohn's disease and Indeterminate Colitis, clearly emerges from our observation, which could postulate a possible alteration of collagen development in the pathophysiology and clinical spectrum of UC only and not of IBD in general. These data, however, need to be confirmed and further investigated in the future with focused and rigorous prospective clinical studies, excluding confusing factors such as young age or inflammatory joint diseases such as spondyloarthritis. <h3>References</h3> [1]Pizzi LT, Weston CM, Goldfarb NI, Moretti D, Cobb N, Howell JB, Infantolino A, Dimarino AJ, Cohen S. Impact of chronic conditions on quality of life in patients with inflammatory bowel disease. Inflamm Bowel Dis. 2006 Jan;12(1):47-52. [2]Kaplan GG. The global burden of IBD: from 2015 to 2025. Nat Rev Gastroenterol Hepatol. 2015;12(12):720–7. [3]Castori M, Tinkle B, Levy H, Grahame R, Malfait F, Hakim A. A framework for the classification of joint hypermobility and related conditions. Am J Med Genet Part C Semin Med Genet 2017; 175;148–57. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.